基于《四部医典》和临床医案的京尼萨克病(Ⅱ型糖尿病)尿诊特征知识发现研究

A Study on Knowledge Discovery of Urinary Diagnosis and Jenesake Disease in Tibetan Medicine(Type II Diabetes)Based on the Four Tantras and Clinical Recordings

目的挖掘整理《四部医典》尿诊内容,并基于临床医案将京尼萨克病(Ⅱ型糖尿病)尿诊隐形经验知识可视化。探索将藏医药原创思维、临床诊疗与现代科学技术对接和临床隐形经验知识的数字化、可视化。方法通过文献法深入挖掘《四部医典》尿诊内容,并采用Gephi、Spsspro、中医传承计算平台等软件分析355例京尼萨克病临床医案。结果藏医尿诊历史源远流长,距今约有上千年的发展史,具有系统完整的理论体系。《四部医典》中记载的藏医尿诊三时九诊法独具特色,对临床疾病诊断起着重要作用。对355例京尼萨克病临床医案分析得出,尿诊因证型不同而略有不同,总体呈现颜色淡黄、青色、黄色,较为明亮,接近正常尿液颜色;蒸汽、气味均大;泡沫青而大或消散快;悬浮物少或呈毛状;漂浮物薄;变化时间多为热气未散完即开始转变;变化方式从中间薄处开始向边缘转变;回旋情况由稀变稠等特征。对尿诊证型频次分析得到赤巴型139次,隆型91次,培根型88次,培赤型34次。结论藏医尿诊具有完整的理论体系、丰富的临床实践经验。本文通过文献挖掘和临床医案相结合的方法,扩展了藏医京尼萨克病尿诊三时九诊内容,将藏医药原创思维与现代信息化技术结合实现了藏医京尼萨克病尿诊隐形经验知识的可视化。

Objective This essay excavates the contents of urinary diagnosis in the Four Tantras and visualize the invisible experience knowledge of urinary diagnosis of Jenesake disease(type II diabetes)based on clinical medical records.It also explores the digitization and visualization of original thinking of Tibetan medicine,clinical diagnosis and treatment and modern science and technology,and clinical invisible experience and knowledge.Methods The contents of urinary diagnosis in the Four Tantras were deeply explored by literature method.And 355 cases of Jenesake disease c were analyzed by Gephi,Spsspro,traditional Chinese medicine inheritance computing platform and other software.Results Urology in Tibetan medicine has a long history,with a development period of one thousand years and has a systematic and complete theoretical system.The three-times and nine-diagnosis method of urinary in Tibetan medicine recorded in the Four Tantras is unique and plays an important role in the diagnosis of clinical diseases.According to the analysis of 355 clinical cases of Jenesake disease,urine diagnosis was slightly different according to different syndrome types,the overall color was light yellow,cyan,yellow,relatively bright,close to normal urine color.Steam and smell are big;The foam is bluish and large or dissipates quickly;Few or hairy suspensions;The float is thin;Change time for the hot gas is not finished began to change;The pattern of change from the thin middle to the edge;Cyclotron condition from thin to thick and other characteristics.The frequency analysis of urinary diagnosis syndromes showed that 139 cases of Chiba type,91 cases of lung type,88 cases of bacon type and 34 cases of Pechi type.Conclusion Urology in Tibetan medicine has a complete theoretical system and rich experience in clinical practice.Through the method of combining literature mining and clinical medical cases,this paper expands the contents of the three-time and nine-time urine diagnosis of Jenesake disease in Tibetan medicine and combines the original thinking of Tibetan medicine with modern information technology to realize the visualization of the invisible experience knowledge of Jenesake disease urine diagnosis in Tibetan medicine.